PDF(Pubmed)
Abstract：
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system but can also lead to neurological complications. Among COVID-19 patients, the endothelium is considered the Achilles heel. A variety of endothelial dysfunctions may result from SARS-CoV-2 infection and subsequent endotheliitis, such as altered vascular tone, oxidative stress, and cytokine storms. The cerebral hemodynamic impairment that is caused is associated with a higher probability of severe disease and poor outcomes in patients with COVID-19. This review summarizes the most relevant literature on the role of vasomotor reactivity (VMR) in COVID-19 patients. An overview of the research articles is presented. Most of the studies have supported the hypothesis that endothelial dysfunction and cerebral VMR impairment occur in COVID-19 patients. Researchers believe these alterations may be due to direct viral invasion of the brain or indirect effects, such as inflammation and cytokines. Recently, researchers have concluded that viruses such as the Human Herpes Virus 8 and the Hantavirus predominantly affect endothelial cells and, therefore, affect cerebral hemodynamics. Especially in COVID-19 patients, impaired VMR is associated with a higher risk of severe disease and poor outcomes. Using VMR, one can gain valuable insight into a patient\'s disease progression and make more informed decisions regarding appropriate treatment options. A new pandemic may develop with the COVID-19 virus or other viruses, making it essential that healthcare providers and researchers remain focused on developing new strategies for improving survival in such patients, particularly those with cerebrovascular risk factors.
摘要：
严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）主要影响呼吸系统，但也可能导致神经系统并发症。在COVID-19患者中，内皮被认为是致命弱点。SARS-CoV-2感染和随后的内皮炎可导致多种内皮功能障碍,比如血管张力改变，氧化应激，和细胞因子风暴。引起的脑血流动力学损害与COVID-19患者发生严重疾病的可能性较高和预后不良相关。这篇综述总结了关于血管舒缩反应性（VMR）在COVID-19患者中的作用的最相关文献。对研究文章进行了概述。大多数研究支持COVID-19患者发生内皮功能障碍和脑VMR损伤的假设。研究人员认为，这些改变可能是由于病毒对大脑的直接入侵或间接影响，如炎症和细胞因子。最近,研究人员得出结论，人类疱疹病毒8和汉坦病毒等病毒主要影响内皮细胞，因此,影响脑血流动力学。特别是在COVID-19患者中，受损的VMR与更高的严重疾病风险和不良预后相关.使用VMR，人们可以获得对患者疾病进展的宝贵见解，并就适当的治疗方案做出更明智的决定。COVID-19病毒或其他病毒可能会爆发新的大流行，这使得医疗保健提供者和研究人员必须继续专注于开发新的策略来提高此类患者的生存率，尤其是那些有脑血管危险因素的人。
